/ YOUTH FUND2014 APPLICATION FORM
Please note: when completing this form please use ‘tab’ to go to the next question or click on the next question to continue
Section one: Questions about you and the supporting organisation
1. / What is the name of your group?
2. / What is the legal name of the organisation supporting you?
Please provide the organisation’s registration number (as per the Companies office):
3. / Has the organisation above received funding from the Ministry of Social Development (MSD), including the Ministry of Youth Development before? BlankYesNo(please select yes or no)
If yes, please provide the organisation’s MSD Provider ID if known:
Please provide the organisation’s GST number if known:
4. / Has the organisation been funded through the Youth Fund before? BlankYesNo(please select yes or no)
5. / Please provide details of someone we can contact if we require more information. This person will also receive all communications from the Ministry of Youth Development
Name:
Position Title:
Contact phone number: / Please select one0304060709
Cell phone number:
Email:
Street address: / , , Postcode:
Postal address (if different from above): / Please select onePO BoxPrivate Bag, , Postcode:
6. / What are the names of two young people involved in the project who we can contact for more information if required?
Name:
Contact phone number:
Name:
Contact phone number:
/ YOUTH FUND2014 APPLICATION FORM
Please note: when completing this form please use ‘tab’ to go to the next question or click on the next question to continue
Section two: Questions about your project
1. / What is the name of your project?
2. / Has this project been funded through the Youth Fund before? BlankYesNo(please select yes or no)
3. / Tell us about the project you would like funded? (limit to 300 words)
4. / Will your project be completed by 30 June 2014?
BlankYesNo(please select yes or no)
5. / On what date(s)will your project happen? or when will your project happen?
Project will happen from to or will be happen on
6. / What skills and knowledge will young people learn by being part of your project? For example, the skills the young people gain from organising and attending a youth forum. (limit to 300 words)
7. / How will your project involve young people in decision-making and leadership? (limit to 300 words)
8. / How is your project responding to a need in the community that young people have identified? (limit to 300 words)
9. / How will your project help young people to be a part of and give back to their community? (limit to 300 words)
10. / What is the age range of the young people who will benefit?
11. / How many young people willbenefit from the project? For example, 10 young people on the organising committee and 100 young people at a youth forum.
12. / What is the name of the City or Town your project will run in?
13. / How much will your project cost? (GST exclusive) / $
14. / How much of this are you asking for from the Youth Fund? Note: The minimum grant amount is $2,000 (GST exclusive) with a maximum grant amount of $7,000 (GST exclusive) / $
15. / Where will you get the rest of the funding from, if required?
16. / In the table below, please provide a description of what the Youth Fund 2014 grant will be used for and the amount: Include any equipment that you will purchase for the project
Description / Expense / Amount
(GST exclusive)
$
$
$
$
$
$
$
Total Youth Fund 2014funding requested[Note: The minimum grant amount is $2,000 (GST exclusive) with a maximum grant amount of $7,000 (GST exclusive)]: / $
Other funders’ contribution (if any) / $
Any ‘in-kind’ contributions (if any) / $
TOTAL COST OF PROJECT: / $
/ YOUTH FUND 2014 APPLICATION FORM
Please note: when completing this form please use ‘tab’ to go to the next question or click on the next question to continue
Section three: Signatures required(Note: electronic copies without signatures are acceptable as long as both the Name and Position fields are completed)
Organisation
Declaration:
I have delegation[1] to sign on behalf of my organisation and agree for the funds to be placed in our account and used for the young people’s project as outlined in this application.
Name:
Position:
Signature:
Date:
Young Person (aged 12 to 24 years)
Declaration:
I declare that:
  • the information in this funding application is accurate to the best of my knowledge
  • I give my permission to be contacted for further details if required
  • I am a current AYV member[2]
  • I confirm that young people have been involved in completing this application.

Name:
Signature:
Phone number:
Email:
Date:

To apply for the fund please complete the funding application form and email it to: is preferred that applications are completed and returned electronically.

Applications close 12pm (midday) on 24September 2013. Please note that late applicationswill not be accepted.

If the application is successful for funding YOU will be the signatory to a legal grant contract with the Ministry of Youth Development

2 To become an AYV member sign up by going to

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[1] If the application is successful for funding YOU will be the signatory to a legal grant contract with the Ministry of Youth Development